RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXX  	CASE:  PD-2017-05809
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20050808

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Air Transportation Craftsman, medically separated for “chondromalacia patella, right knee” with a disability rating of 10%.  

CI CONTENTION:  “I was rated 100% by VA upon discharge.”   The complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The panel’s scope of review is defined in DoDI 6040.44.  It is limited to review of disability ratings assigned to those conditions determined by the Physical Evaluation Board (PEB) to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the Medical Evaluation Board (MEB), but determined by the PEB to be not unfitting or non-compensable.  Any conditions outside the panel’s defined scope of review, and any contention not requested in this application, may remain eligible for future consideration by the Board for Correction of Military Records.  The panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections when appropriate.  The panel gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of disability at the time of separation.  

RATING COMPARISON:  

SERVICE PEB - 20050622	VARD - 20060308	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chondromalacia Patella, Right Knee	5299-5003	10%	Right Knee, Chondromalacia with Degenerative Joint Disease	5010-5260	10%	20051229	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  90%	

ANALYSIS SUMMARY:  

Right Knee Chondromalacia Patella.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI suffered persistent right knee pain following a duty injury in April 2003.  An MRI demonstrated some thinned cartilage and degenerative changes (ligaments and menisci intact), and provider entries documented grossly normal or modestly limited range of motion (ROM) and an intermittently antalgic gait, but no effusion, instability, or impingement.  The 12 April 2005 MEB NARSUM examination, 4 months prior to separation, documented nonspecific right knee pain (no note of subjective locking or instability) that prohibited running, jumping, climbing, and prolonged standing.  The physical examination, taken from an orthopedic consult 2 months earlier on 22 February, recorded a normal gait, tenderness, no effusion, no instability, and no impingement.  Measured ROM showed flexion to 130 degrees (normal 140) and extension to 0 degrees (normal).  

At the 29 December 2005 VA Compensation and Pension (C&P) examination, 5 months after separation, the CI reported right knee pain, rated at 3-4/10, which increased to 7-9/10 with prolonged standing or walking.  The physical examination recorded a normal gait, mild crepitus without note of tenderness, effusion, instability, or impingement.  Flexion was to 118 degrees and extension to 0 degrees.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right knee condition 10%, coded 5299-5003 (analogous to degenerative arthritis).  The VA also rated the condition 10%, coded 5010-5260 (traumatic arthritis rated for limitation of flexion), based on the C&P examination and citing painful motion.  There was no limitation of motion which supported a minimum 10% rating under the diagnostic codes for limitation of flexion or extension (5260, 5261).  There was no evidence of instability (5257), frequent locking with recurrent effusions (5258), or fracture, nonunion or malunion of the femur or tibia to support consideration under the respective codes for knee impairment related to long bone conditions (5255, 5262).  There were no other criteria in evidence to support a rating higher than 10% under any applicable VASRD §4.71a code.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded there was insufficient cause to recommend a change in the PEB adjudication for the right knee condition.

BOARD FINDINGS:  In the matter of the right knee condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  Therefore, the panel recommends that there be no modification or re-characterization of the CI’s disability and separation determination.  

SAF/MRB

Dear XXXXXXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-05809.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no rating modification or re-characterization of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that modification of your disability rating or characterization of your separation is not warranted.  Accordingly, I accept the recommendation that your application be denied.